As a part of NURBN3021 curriculum, we were instructed to participate in an assessment of clinical skills. The assessment required us to undertake a blood culture venepuncture sample under sterile techniques. As I prepared myself for the assessment, I collected the required equipment that was needed for the blood culture sample collection. A clean procedure tray with an antiseptic wipe was taken. I also collected the sterile gauze and plaster along with a cleaning swab and sample collecting device and culture bottle adapter set. While performing the collection, I had sterilized my hands and had to choose the arm of the patient for venepuncture. I had to choose the vein through palpations but the ideal vein that feels “springy” was difficult to locate. After finalizing the position, I had to collect the sample. When collecting the sample, I forgot to sterilize the arm with the disinfectant to clean the arm for sample collection. Before making the puncture, I was reminded that I need to clean and sterilize the site. Finally, I was able to successfully collect the sample for blood culture through venepuncture as required in the assessment.
When the assessment has just begun I was nervous as I felt that I was underprepared. However, once I realized that I have to work through I calmed myself and aligned myself for the deliverables. I was recalling all the steps and the materials required for the successful completion of the assessment to ensure that I could complete the assessment successfully. Once I was able to collect the sample successfully and in a sterilized environment, I felt confident in the technique. It also relieved me from the initial stress and anxiety about the assessment. After the assessment was over I realized that I must work on my experienced limitations and further enhance my practice to develop as a competent nursing professional. I felt confident that through a strong and effective action plan, I will be able to achieve my desired goals for practice and clinical assessments.
The sterilized environment is crucial when a blood sample is collected (Skarparis & Ford, 2018). The sterilization becomes even more crucial in the case of culture. Use of unsterilized techniques in venepuncture can serve to be fatal (Rao et al., 2019). The site of venipuncture must be cleaned with a sterile disinfectant that has 70% isopropyl or ethyl alcohol applied on 5cm X 5 cm gauze, swab or a cotton ball (Reed et al., 2017). The cleaning should be done with a firm but gentle pressure focused on the site of venepuncture to the surrounding area. The process of venepuncture can be applied through three means, that is, through a winged infusion set. Syringe needle method, and the vacuum tube method. All three methods should proceed only after proper sterilization (Inan & Inal, 2019). The process of sterilization is crucial as it helps in the prevention of infection that can occur by trapping of the microbes at the site of venepuncture (Shaw, 2018). Further, in the blood culture, the presence of contaminant would result in failure to develop successful blood cultures. The most common type of disinfectant that is used in 70%. venepuncture is isopropyl alcohol in towelette form (Coventry et al., 2019). When I was conducting the assessment, I was initially nervous as I acknowledged the importance of each step and did not want to lose control of any situation. This resulted in the creation of minor anxiety before participation. However, as I frequently recalled each step, I was able to remember and follow each step. I was able to recall the steps if sterilization and follow the moments of hygiene crucial before clinical assessments. This helped me successfully complete the assessment and achieve the desired results. At the end of the assessment, I realized that I was now more confident with the conduct of venepunctures and was relieved.
Venepuncture is an important nursing skill as it is frequently used and applied for various conditions where the drawing of blood is necessary (Gaikwad et al., 2018). Therefore, the assessment helped in the evaluation of the skill but also in the identification of the strengths and lacuna that can be further improved to advance as a competent nurse (Mayfield, 2018). Through this assessment, I was able to identify that I have satisfactory knowledge of the procedure and must advance on my skills to be more confident and to enhance my ability to perform venepunctures in future. Through this assessment, I have also been able to analyses the importance of sterilization in the process of venepunctures. I have developed knowledge that through effective sterilizations the risk of infection on the patient can be reduced, further, in blood cultures, presence of contaminants can affect the overall quality of culture having a significant impact on the research. Therefore, sterilisation and hygiene in venepunctures should be given excessive attention and should be followed at each requisite step.
The purpose of this assessment was to help in the analysis of practical knowledge and clinical skills. Through this assessment, I was able to identify my strengths and weaknesses. The overall experience of this assessment can be defined as a learning experience that helped me understand how theoretical knowledge can be applied and to assess our performances. Through this assessment, I have concluded that I need to improve my skills as a clinical practitioner to further improve my competencies.
To enhance my practice as a nursing professional, I aim to improve my clinical practice like that of venepuncture and develop confidence in practice through a planned and systematic approach. I will develop confidence in my skill by exposing myself to sufficient practice. I will participate in training and gain clinical experience to develop confidence in completing the clinical assessments (Giddens, 2019). Further, I will set SMART goals for myself for the improvement of my identified lacuna. SMART goals will help in the development of a systematic approach that is specific, measurable, achievable, relevant, and timely (Grove & Gray, 2018). This will help me have a clear goal focused on the improvement of my clinical skills and help in the assessment of the progress. Further, I will also ensure that I read the relevant research material and academic data that can help me understand the application of clinical assessments and help in performing them (Grove & Gray, 2018). I will also observe my senior facilitators and learn the techniques more accurately to achieve the desired results. To minimize my stress and nervousness, I will build on my leadership skills and gain confidence through applied practice and experiential learning (Grove & Gray, 2018). I will also focus on reducing my stress by focusing on the strengths and by working to improve my limitations (Giddens, 2019). Through these actions, I am to advance as a competent healthcare professional who is proficient in practice and clinical assessments like venepuncture.
Coventry, L. L., Jacob, A. M., Davies, H. T., Stoneman, L., Keogh, S., & Jacob, E. R. (2019). Drawing blood from peripheral intravenous cannula compared with venepuncture: A systematic review and meta‐analysis. Journal of Advanced Nursing, 75(11), 2313-2339. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14078
Gaikwad, U. N., Basak, S., Kulkarni, P., Sande, S., Cahavan, S., Mudey, G., ... & Gaikwad, N. R. (2018). Educational intervention to foster best infection control practices among nursing staff. Journal of Advanced Nursing 5(3), 81531. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14078
Giddens, J. F. (2019). Concepts for Nursing Practice E-Book. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=5nTADwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice+book&ots=oYAW9bdzlv&sig=_V3Y5IRrqrXM4qF_clgRU6-C3Q8
Grove, S. K., & Gray, J. R. (2018). Understanding nursing research e-book: Building an evidence-based practice. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=cxNkDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice+book&ots=nTyV_F7SfW&sig=1MlHsmBHT1baZ0Obx2DAomrEBqg
Inan, G., & Inal, S. (2019). The impact of 3 different distraction techniques on the pain and anxiety levels of children during venipuncture. The Clinical Journal of Pain, 35(2), 140-147. https://www.ingentaconnect.com/content/wk/cjpn/2019/00000035/00000002/art00005
Mayfield, E. (2018). The use of disinfectant barrier end caps to prevent blood stream infections. Journal of Advanced Nursing, 75(11), 2313-2339. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14078
Rao, P. B., Mohanty, C. R., Singh, N., Mund, M., Patel, A., & Sahoo, A. K. (2019). Effectiveness of different techniques of ethyl chloride spray for venepuncture-induced pain: A randomised controlled trial. Anesthesia, Essays and Researches, 13(3), 568. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6775824/
Reed, S., Remenyte-Prescott, R., & Rees, B. (2017). Effect of venepuncture process design on efficiency and failure rates: A simulation model study for secondary care. International Journal of Nursing Studies, 68, 73-82. https://www.sciencedirect.com/science/article/pii/S0020748916302474
Shaw, S. J. (2018). How to undertake venepuncture to obtain venous blood samples. Nursing Standard, 32(29), 41-47. https://journals.rcni.com/doi/aop-pdf/10.7748/ns.2018.e10531
Skarparis, K., & Ford, C. (2018). Venepuncture in adults. British Journal of Nursing, 27(22), 1312-1315. https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2018.27.22.1312
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